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mrcp 1 > clinical pharma/toxicol > Flashcards

clinical pharma/toxicol Flashcards

1
Q

Poor pupillary responses bilaterally, macular oedema, low GCS, raised anion gap metabolic acidosis?

A

Methanol poisoning

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2
Q

Causes of urticaria?

A

aspirin
penicillins
NSAIDs
opiates

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3
Q

Which receptor does Herceptin work on?

A

HER2

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4
Q

Letrozole and tamoxifen work on which hormone?

A

Oestrogen +ve

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5
Q

Partial agonist of the mu-opioid receptor and an antagonist of the kappa-opioid receptor?

A

Buprenorphine

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6
Q

History of suicide attempts presenting with metabolic acidosis characterised by an elevated anion gap and a high lactate level? Normal vitals and vision.

A

Ethylene glycol

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7
Q

PC BRAS

Enzyme induction?

Induction reduces INR

A

Phenytoin, carbamaz, barbs, rifampicin, alcohol XS, sulphonylureas (diabetic -zide drugs)

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8
Q

AODEVICES

Enzyme inhibition?

A

Allopurinol, omeprazole, disulfiram, erythromycin, valproate, isonazid, cipro, cimetidine, ethanol intox, sulphonamides

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9
Q

Anti TNF antibody?

A

Infliximab

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10
Q

Anti CD20 antibody?

A

Rituximab

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11
Q

EGFR antagonist?

A

Cetuximab

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12
Q

Widened QRS or arrhythmia in drug overdose - dx and rx?

A

IV bicarb for TCA overdose

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13
Q

Immunosuppresant inhibiting calcineurin thus decreasing IL-2?

A

Ciclosporin

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14
Q

Sodium channel blocker? Also known as pill in the pocket?

A

Flecanide

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15
Q

COCP - increases risk of which cancers and decreases risk of which cancers?

A

Increased - breast and cervical, Decreased - endometrial and ovarian

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16
Q

Urinalysis with ‘muddy brown casts’?

A

Acute tubular necrosis

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17
Q

TB drugs - side effects?

A

Rifampicin - orange urine
Isonazid - peripheral neuropathy
Pyrazinamide - hepatotoxicity and hyperuricemia
Ethambutol - optic neuritis

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18
Q

Visual field defects, hearing loss and paraesthesia? What type of poisoning?

A

Mercury

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19
Q

How long to wait before increasing metformin dose?

A

Leave at least 1 week before increasing dose

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20
Q

Drug used to induce remission in first presentation of Crohns?

A

Prednisolone

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21
Q

Cherry pink skin colour, drowsiness, hypervent, hypotension?

A

Carbon monoxide poisoning

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22
Q

Is nitro safe during pregnancy for UTI?

A

Yes

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23
Q

Palpitations on digoxin?

A

Premature ventricular beats - toxicity

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24
Q

Signs of ACS - anticholinergic syndrome?

A

Flushing, dry skin and mucus membranes

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25
Q

After starting statin, should LFTs and lipid profiles be checked 1M later or 3M later?

A

3 months

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26
Q

Hyper or hypothyroidism due to amiodarone?

A

Hyperthyroidism

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27
Q

MDMA (Ecstasy) poisoning is associated with what abnormality?

A

Hyponatraemia

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28
Q

Mercury poisoning can cause which abnormalities?

A

Paraesthesia
visual field defects
hearing loss

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29
Q

Macular oedema, poor pupillary responses, and raised anion gap acidosis?

A

Methanol

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30
Q

Flecainide mechanism?

A

Blocks sodium channels -

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31
Q

Buprenorphine mechanism?

A

Partial agonist of the mu-opioid receptor and an antagonist of the kappa-opioid receptor

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32
Q

Levothyroxine works on which receptors?

A

Nuclear receptors

33
Q

How does NAC help in overdose?

A

N-acetylcysteine is a precursor of glutathione - this joins with active metabolite to create non toxic substance

34
Q

What happens in heparin-induced thrombocytopaenia?

A

Antibodies form against complexes of platelet factor 4 (PF4) and heparin

35
Q

MI secondary to cocaine use?

A

Patients with MI secondary to cocaine use should be given IV benzodiazepines as part of acute (ACS) treatment

36
Q

Medications for motion sickness (in order of efficacy)?

A

Hyoscine > cyclizine > promethazine

37
Q

ER negative and HER-2 positive breast cancer?

A

Trastuzumab (Herceptin)

38
Q

ER-positive early-stage breast cancer?

A

Aromatase inhibitor - decreases peripheral oestrogen synthesis

39
Q

Most useful prognostic marker in paracet OD?

A

Elevated prothrombin time

40
Q

Direct Xa inhibitors?

A

DOACs - except dabig

41
Q

Direct thrombin inhibitor?

42
Q

Clotting factor inhibitor?

43
Q

Inhibits the formation of thromboxane A2?

44
Q

Inhibits factor Xa but does so via activation of antithrombin III?

45
Q

Kidney injury caused by gent?

46
Q

What is the most important investigation to perform prior to initiating Herceptin?

A

ECHO - cardiac toxicity

47
Q

Phenylephrine?

A

Alpha 1 agonist

48
Q

Dobutamine?

A

Beta 1 agonist

49
Q

Salbutamol?

A

Beta 2 agonist

50
Q

Clonidine?

A

Alpha 2 agonist

51
Q

Cyanide poisoning rx?

A

Hydroxocobalamin

52
Q

Indication for haemodialysis in salicylate OD?

A

Serum concentration > 700mg/L

53
Q

Which drug not cleared by dialysis?

54
Q

Ciclosporin monitoring?

A

Level just before next dose

54
Q

Acetazolamide?

A

Carbonic anhydrase inhibitor

55
Q

Brimonidine?

A

Alpha 2 agonist

56
Q

Latanoprost?

A

Prostaglandin analogue

57
Q

Timolol?

A

Beta antagonist

58
Q

Pilocarpine?

A

Musc agonist

59
Q

Does adrenaline increase or decrease lactate production?

60
Q

Mechanism of abciximab?

A

Glycoprotein IIb/IIIa receptor antagonist

61
Q

Accumulation of acetylcholine sx?

A

Salivation, Lacrimation, Urination, Diarrhoea

62
Q

Indication for haemodialysis in lithium toxicity?

63
Q

Severe serotonin syndrome treatment?

A

Cyproheptadine

64
Q

Electrolyte imbalance in hypomag?

A

QT prolongation

65
Q

Amiloride mechanism?

A

Blocks the epithelial sodium channel in the distal convoluted tubule

66
Q

Tamsulosin mechanism?

A

Alpha 1a antagonist

67
Q

Amiodarone-induced thyrotoxicosis (AIT) may be divided into two types - AIT 1 + AIT2?

A

AIT1 - no thyroiditis, goitre, carbimazole or potassium perchlorate
AIT2 - thyroiditis, no goitre, steroids

68
Q

Describe drug metabolism phases?

A

phase I: oxidation, reduction, hydrolysis
phase II: conjugation

69
Q

Mixed respiratory alkalosis and metabolic acidosis in a sweaty, confused patient?

A

Salicylate poisoning - aspirin

70
Q

Beta-blocker overdose management?

A

Atropine + glucagon

71
Q

Inhibition of 50S/30S subunit?

A

50S - macrolides i.e. clary
30S - tetracyclines i.e. doxy

72
Q

Organophosphate insecticide antidote?

73
Q

Quinolones (e.g. ciprofloxacin) mechanism?

A

Inhibits DNA synthesis

74
Q

Paracetamol overdose mechanism?

A

Occurs when glutathione stores run-out leading to an increase in NAPQI (N-acetyl-p-benzoquinone imine)

75
Q

What normally happens to blood pressure during pregnancy?

A

Falls in first half of pregnancy before rising to pre-pregnancy levels before term.

76
Q

Tests for Addisons and Cushings?

A

Addisons - ACTH stim
Cushings - dexa suppression

77
Q

Which abx can cause pancytopenia?

A

Trimethoprim

mrcp 1 (18 decks)

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